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To explore whether and how group cognitive-behavioural therapy (GCBT) plus medication differs from medication alone for the treatment of generalized anxiety disorder (GAD).
170 patients were randomly assigned to the GCBT plus duloxetine (n=89) or duloxetine group (n=81). The primary outcomes were Hamilton Anxiety Scale (HAMA) response and remission rates. The explorative secondary measures included score reductions from baseline in the HAMA total, psychic and somatic anxiety subscales (HAMA-PA, HAMA-SA), the Hamilton Depression Scale (HAMD), the Severity Subscale of Clinical Global Impression Scale (CGI-S), Global Assessment Function (GAF), and the 12-item Short-Form Health Survey (SF-12). Assessments were conducted at baseline, 4-weeks, 8-weeks and 3-monthsfollow-up.
At 4-weeks, HAMA response (GCBT group 57.0% vs. control group 24.4%, p=0.000, Cohen d=0.90) and remission rates (GCBT group 21.5%vs. control group 6.2%, p=0.004; d=0.51), and most secondary outcomes (all p<0.05, d=0.36-0.77) showed that the combined therapy was superior. At 8-weeks, all the primary and secondary significant differences found at 4-weeks were maintained with smaller effect sizes (p<0.05, d=0.32-0.48) . At 3-months follow-up, the combined therapy was only significantly superior in the HAMA total (p<0.045, d=0.43) and HAMA-PA score reductions (p<0.001, d=0.77). Logistic regression showed superiority of the combined therapy for HAMA response rates (OR=2.12, 95% CI 1.02-4.42, p=0.04); and remission rates (OR=2.80, 95% CI 1.27-6.16, p=0.01).
Compared with duloxetine alone, GCBT plus duloxetine showed significant treatment response for GAD over a shorter period of time, particularly for psychic anxiety symptoms, which may suggest GCBT was effective in changing cognitive style.
In order to solve joint-angle drift problem of dual redundant manipulators at acceleration-level, an acceleration-level tri-criteria optimization motion planning (ALTC-OMP) scheme is proposed, which combines the minimum acceleration norm, repetitive motion planning, and infinity-norm acceleration minimization solutions via weighting factor. This scheme can resolve the joint-angle drift problem of dual redundant manipulators which will arise in single criteria or bi-criteria scheme. In addition, the proposed scheme considers joint-velocity joint-acceleration physical limits. The proposed scheme can not only guarantee joint-velocity and joint-acceleration within their physical limits, but also ensure that final joint-velocity and joint-acceleration are near to zero. This scheme is realized by dual redundant manipulators which consist of left and right manipulators. In order to ensure the coordinated operation of manipulators, two motion planning problems are reformulated as two general quadratic program (QP) problems and further unified into one standard QP problem, which is solved by a simplified linear-variational-inequalities-based primal-dual neural network at the acceleration-level. Computer-simulation results based on dual PUMA560 redundant manipulators further demonstrate the effectiveness and feasibility of the proposed ALTC-OMP scheme to resolve joint-angle drift problem arising in the dual redundant manipulators.
To compare and validate neurocognitive tests in the Harmonized Cognitive Assessment Protocol (HCAP) for the China Health and Retirement Longitudinal Study (CHARLS), and to identify appropriate tests to be administered in future waves of CHARLS.
We recruited 825 individuals from the CHARLS sample and 766 subjects from hospitals in six provinces and cities in China. All participants were administered the HCAP-neurocognitive tests, and their informants were interviewed regarding the respondents’ functional status. Trained clinicians administered the Clinical Dementia Rating scale (CDR) to assess the respondents’ cognitive status independently.
The testing protocol took an average of 58 minutes to complete. Refusal rates for tests of general cognition, episodic memory, and language were less than 10%. All neurocognitive test scores significantly correlated with the CDR global score (correlation coefficients ranged from 0.139 to 0.641). The Mini-Mental State Examination (MMSE), the Health and Retirement Study (HRS) - telephone interview for cognitive status (TICS), community screening instrument for dementia (CSI-D) for respondent, episodic memory and language tests each accounted for more than 20% of the variance in global CDR score (p < 0.001) in bivariate tests. In the CHARLS subsample, age and education were associated with neuropsychological performance across most cognitive domains, and with functional status.
A brief set of the CHARLS-HCAP neurocognitive tests are feasible and valid to be used in the CHARLS sample and hospital samples. It could be applied in the future waves of the CHARLS study, and it allows estimating the prevalence of dementia in China through the population-based CHARLS.
Previous studies have indicated that there is dopamine transporter (DAT) dysregulation and P300 abnormality in adults with attention-deficit hyperactivity disorder (ADHD); however, the correlations among the three have not been fully explored.
A total of 11 adults (9 males and 2 females) with ADHD and 11 age-, sex-, and education-level-matched controls were recruited. We explored differences in DAT availability using single-photon emission computed tomography and P300 wave of event-related potentials between the two groups. The correlation between DAT availability and P300 performance was also examined.
DAT availability in the basal ganglia, caudate nucleus, and putamen was significantly lower in the ADHD group. Adults with ADHD had lower auditory P300 amplitudes at the Pz and Cz sites, as well as longer Fz latency than controls. DAT availability was negatively correlated to P300 latency at Pz and Fz.
Adults with ADHD had both abnormal DAT availability and P300 amplitude, suggesting that ADHD is linked to dysfunction of the central dopaminergic system and poor cognitive processes related to response selection and execution.
The study of emoticon use in text communication is in its early stages (Aragon, Feldman, Chen & Kroll, 2014), with even less known about how emoticons function in multilingual environments. We describe a preliminary longitudinal analysis of text communication in an online bilingual scientific work environment and demonstrate how patterns of emoticon use constitute a novel yet systematic nonverbal aspect of communication. Specifically, coordination over bilingual speakers entails reductions in emoticon diversity over time that are greater for those who communicate in their L2 than in their L1. An analogous but weaker pattern is evident for lexical diversity in L2 but not L1. We hypothesize that reductions in emoticon diversity in the L2 are likely to reflect social contributions to alignment rather than purely proficiency.
We draw parallels between emoticons in textual communication and gesture in signed language with respect to the interdependence of codes by describing two contexts under which the behavior of emoticons in textual communication resembles that of gesture in speech. Generalizing from those findings, we propose that gesture is likely characterized by a nuanced interdependence with language whether signed, spoken or texted.
To track the course of development in children's fine-grained perception of Mandarin tones, the present study explored how categorical perception (CP) of Mandarin tones emerges along age among 70 four- to seven-year-old children and 16 adults. Prominent discrimination peaks were found for both the child and the adult groups, and they were well aligned with the corresponding identification crossovers. Moreover, six-year-olds showed a much narrower width (i.e. a sharper slope) compared to younger children, and have already acquired adult-like identification competence of Mandarin high-level and mid-rising tones. Although the ability to discriminate within-category tone pairs did not change, the between-category discrimination accuracies were positively correlated with chronological ages among child participants. We assume that the perceptual refinement of Mandarin tones in young children may be driven by an accumulation of perceptual development from the tonal information of the ambient sound input.
We study optimal double stopping problems driven by a Brownian bridge. The objective is to maximize the expected spread between the payoffs achieved at the two stopping times. We study several cases where the solutions can be solved explicitly by strategies of a threshold type.
Multiferroic magnetoelectric nanostructures with coupled magnetization and electric polarization across their interfaces have stimulated intense research activities over the past decade. Such interface-based magnetoelectric coupling can be exploited to significantly improve the performance of many devices such as memories, tunable radio-frequency/microwave devices, and magnetic sensors. In this article, we introduce a number of current or developing technologies and discuss their limitations. We describe how the use of magnetoelectric nanostructures can overcome these limitations to optimize device performance. We also present challenges that need to be addressed in pursuing practical applications of magnetoelectric devices.
The prevalence and factors associated with delays in help seeking for people with dementia in China are unknown.
Within 1,010 consecutively registered participants in the Clinical Pathway for Alzheimer's Disease in China (CPAD) study (NCT01779310), 576 persons with dementia (PWDs) and their informants reported the estimated time from symptom onset to first medical visit seeking diagnosis. Univariate analysis of general linear model was used to examine the potential factors associated with the delayed diagnosis seeking.
The median duration from the first noticeable symptom to the first visit seeking diagnosis or treatment was 1.77 years. Individuals with a positive family history of dementia had longer duration (p = 0.05). Compared with other types of dementia, people with vascular dementia (VaD) were referred for diagnosis earliest, and the sequence for such delays was: VaD < Alzheimer's disease (AD) < frontotemporal dementia (FTD) (p < 0.001). Subtypes of dementia (p < 0.001), family history (p = 0.01), and education level (p = 0.03) were associated with the increased delay in help seeking.
In China, seeking diagnosis for PWDs is delayed for approximately 2 years, even in well-established memory clinics. Clinical features, family history, and less education may impede help seeking in dementia care.
During 1997–2012 we conducted a nationwide camera-trapping survey and assessed the availability of prey and habitat for the clouded leopard Neofelis nebulosa in Taiwan. We surveyed 1,249 camera-trap sites over 113,636 camera-trap days, from the seashore to an altitude of 3,796 m and covering various types of vegetation. No clouded leopards were photographed during 128,394 camera-trap days, including at 209 sites in other studies, confirming the presumed extinction of clouded leopards in Taiwan. Assessment of the prey base revealed altitudinal distribution patterns of prey species and prey biomass. Areas at lower altitudes and with less human encroachment and hunting supported a higher prey biomass and more of the typical prey species of clouded leopards. Habitat analysis revealed 8,523 km2 of suitable habitat but this was reduced to 6,734 km2 when adjacent areas of human encroachment were subtracted. In the absence of hunting and large mammalian carnivores the major prey of clouded leopards in Taiwan, such as Formosan macaques Macaca cyclopis, Reeves's muntjacs Muntiacus reevesi, Formosan serow Capricornis swinhoei and sambar Rusa unicolor, could become over-abundant. Thus, it is important to address the cascading effect of the disappearance of top-down predator control. Our assessment indicated that, with proper regulation of hunting, habitat restoration and corridor improvement, it may be possible to reintroduce the clouded leopard.
Introduction: stem/progenitor cell recruitment vs. transplantation
The utilization of transplanted stem cells in regenerative medicine has been studied extensively as a potential therapy to repair or replace tissues that are lost due to trauma, congenital deformities, tumor resections, or infectious diseases [1–3]. The current cell transplantation model in regenerative medicine is founded on the principle that the application of transplanted stem cells could repopulate and regenerate damaged or diseased tissues, with restored tissue functions and homeostasis. However, cell transplantation is faced with a multitude of clinical and cell culture complications including the complexity of the multistep surgical procedures, donor-site trauma, immune rejection for allogeneic and xenogeneic cells, cell phenotypic variations due to in-vitro culture techniques, potential tumorigenesis associated with long-term cell expansion, failure of exogenous cell engraftment, and uncertainties and difficulties in the regulatory approval process [4–8]. The difficulties in the clinical application of stem cell transplantation are in strong contrast to the results of multiple experimental studies that demonstrate different levels of efficacy of cell delivery in a number of disease models such as Parkinson’s disease [9, 10], blood cancers and diseases [11, 12], and muscle and spinal disorders/injuries [13, 14].
For a number of regenerative medicine applications, the use of stem cell transplantation might not be competitive with the cost-effectiveness of current clinical treatment modalities in the dental and musculoskeletal fields, including titanium joint replacements, dental implants, and operative dental procedures [15–17]. Alternatively, the concept of endogenous stem/progenitor cell recruitment in regenerative medicine is based on the idea that native stem/progenitor cells that already reside within mature tissue can be stimulated and functionally enhanced to repopulate, repair, and/or regenerate damaged tissues . Relative to stem cell transplantation, the application of endogenous stem cell recruitment in regenerative medicine is still in its infancy. The combination of the use of biological factors, release technology, biomaterials, and bioengineered scaffolds to enhance endogenous stem cell recruitment seems very promising for potential use in translational regenerative medicine. However, further scientific experimentation is warranted, since many scientific questions concerning the mechanistic details remain unresolved and it will be necessary to validate the efficacy of this approach for clinical application.
The distribution of the endemic threatened plant Camellia changii Ye (Family Theaceae) is restricted to a small area in southern China, and little else is known about its status in the wild. To provide information for the conservation of C. changii we investigated its distribution, population size and structure, and habitat, and assessed its conservation status. Surveys confirmed that the species grows in a narrow band along both sides of a 4 km long segment of a stream in Ehuangzhang Nature Reserve, under the discontinuous canopy of a secondary evergreen broadleaved forest on well-drained, acidic sandy loam soil. We found a total of 1,039 individuals of C. changii. The population has a high flowering rate but a low seed-setting rate. The population appears to be in decline because no seedlings and few young plants were evident. Our findings indicate that C. changii should be categorized as Critically Endangered on the IUCN Red List. We have recommended an integrated species-conservation plan for the species that includes patrolling the Ehuangzhang Nature Reserve to prevent plant removal, establishing an ex situ living collection that contains the entire wild genetic diversity (accomplished by grafting of short cuttings from all wild individuals), facilitating propagation for commercial use, and implementing reintroduction to augment the wild population.
In order to obtain the dynamic variation rule of the sulfur content of liquid steel in
the LF refining process, a complete mathematical model including a desulfurization kinetic
model and temperature model in the deep desulfurization process is presented, based on the
practical production and reaction mechanism of ultra-low-sulfur steel in a LF. The results
show that the calculated values of the sulfur content in liquid steel using the model fit
the experimental values well, and the relative error is less than 8%. The effects of
refining slag on the desulfurization process are analyzed in this paper, which shows that
slag basicity is most important at the early and middle stages of the process, while slag
weight is most important at the middle and late stages. The effect of the above factors on
the final sulfur content of liquid steel is further analyzed quantitatively. The simulated
results provide a theoretical basis to segment control the refining process in order to
achieve the maximum effect, improving efficiency, saving energy and reducing
A sediment core from the Pearl River Estuary (PRE) was analyzed for grain size and organic geochemistry parameters (TOC and δ13Corg). The results showed that high mean grain-size value and increased sand content were correlated with the high TOC and negative δ13Corg. These results indicated high river runoff in the PRE area. Peak river discharge occurred during the periods 1900–1750, 1500–1600, 1400–1200, 1000–900 and 750–600 cal yr BP. The main changes recorded in grain-size distributions, TOC contents, and δ13Corg variations appear to be directly related to monsoon precipitation in the sediment source area. An increased East Asian summer monsoon rainfall (EASM) and/or an enhanced East Asian winter monsoon rainfall could result in the increasing of monsoon rainfall. Typhoon related rainfalls could act as positive influence on precipitation levels. The study of the correlations between the rainfall records and ENSO activities revealed a close relationship between the monsoon rainfall in the PRE and the tropical Pacific variations. The frequent occurrence of ENSO might result in the southern migration of the EASM rain belt and lead to more typhoon-derived rainfall in the PRD during the late Holocene.
In this work, the effects of annealing treatment on the crystalline structure and mechanical property changes of polypropylene random copolymer (PPR) were comparatively investigated. Wide angle x-ray diffraction and differential scanning calorimetry were used to study the crystalline structure evolution of the annealed PPR sample. The relaxation behavior of the annealed PPR sample was analyzed using dynamic mechanical analysis. The mechanical properties and the toughening mechanism were also investigated. The results showed that the crystalline structure evolution of the annealed PPR sample depended on the annealing temperature. Due to the largely increased molecular chain mobility in the amorphous region, which promoted the plastic deformation of the annealed PPR sample under the impact condition, largely enhanced impact strength was achieved at a moderate annealing temperature. Further results showed that relatively shorter annealing duration could induce the apparent changes of crystalline structure and mechanical properties of the PPR sample.